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CALIFORNIA PUBLIC EMPLOYEES' RETIREMENT SYSTEM <br />Actuarial and Employer Services Division <br />Public Agency Contract Services <br />P.O. Box 942709 <br />Sacramento, CA 94229-2709 <br />(916) 326-3420 <br />I hereby certify that the <br />CERTIFICATION <br />OF <br />FINAL ACTION OF GOVERNING BODY <br />(governing body) <br />of the <br />(public agency) <br />adopted on , by an affirmative vote of a majority of the members of said <br />(date) <br />Governing Body, No. approving the <br />(Ordinance or Resolution) <br />attached contractual agreement between the Governing Body of said Agency and the Board of <br />Administration of the 'California Public Employees' Retirement System, a certified copy of said <br />in the form furnished by said Board of Administration <br />(Ordinance or Resolution) <br />being attached hereto. <br />Clerk/Secretary <br />Title <br />Date <br />PERS-CON-5 (Rev. ]/96) <br />